Animation as Supplementary Learning Material About Carcinogenic Liver Fluke in Classes for Primary Schoolchildren.

Carcinogenic liver fluke is still an issue of great concern in some countries of Southeast Asia, particularly in Thailand, Cambodia, the Lao People's Democratic Republic, and Vietnam. The infection, caused by Opisthorchis viverrini, is associated to cholangiocarcinoma and is endemic among human populations for whom raw fish is frequently consumed. Prevention and health education are required. Therefore, this study aimed to evaluate the effectiveness of educational intervention to improve knowledge among primary schoolchildren based on animation-assisted education. In this study, 80 participants (40 participants in the experimental group and 40 participants in the comparison group) were selected in 2018. The effectiveness of an interactive animation program in improving the knowledge of students studying liver fluke was determined based on scores on tests given before and immediately after completion of a 4.29-min animated program on the liver fluke life cycle, risk factors, disease, diagnosis, treatment, prevention, and control. Data were analyzed using SPSS-22 via paired t tests and independent samples t tests at a significance level of 0.05. A marked and significant improvement was observed in the immediate posttest compared with the pretest scores. More importantly, the students who had used the animated program achieved a significantly higher score on the final test than the comparison group. The results offered in the first report show that the use of the animated program facilitated education about liver fluke. It is strongly believed that animations are good supplementary learning materials for students, particularly for learning about serious concepts.

Effect of Educational Intervention Based on the Health Belief Model and Self-Efficacy in Promoting Preventive Behaviors in a Cholangiocarcinoma Screening Group.

Cholangiocarcinoma (CCA) is a neoplasm known as one of the most common causes of cancer-related deaths in Southeast Asia, particularly in Thailand, Laos, and Cambodia. Prevention and health education are required. Therefore, this study aimed to determine the effectiveness of an educational intervention to prevent CCA among a rural population in Thailand based on the health belief model (HBM) and self-efficacy frameworks. In this quasi-experimental study, 60 participants (30 participants in the experimental group and 30 participants in the control group) were selected in 2017. The educational intervention for the experimental group consisted of seven training sessions (introduction to CCA, risk factors, complications, benefits and barriers to proper consumption of cooked fish, carcinogenic agents, behavioral protection, and self-efficacy in applying preventive behaviors). A questionnaire that consisted of demographic information, knowledge, and HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) was used to measure CCA preventive behaviors before and 3 months after the intervention. Data were analyzed using SPSS-22 via chi-squared, paired t-tests, and independent samples t tests at a significance level of 0.5. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and CCA preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and self-efficacy in the adoption of CCA preventive behaviors 3 months post intervention in the risk group. Thus, these models may serve as a framework for designing and implementing educational interventions for the prevention of CCA.

Nutritional Status among Schoolchildren in the Risk Areas of Liver Fluke Infection, Surin Province, Thailand.

Background: Opisthorchis viverrini is endemic in the Lower Mekong Basin, including Thailand, Lao People's Democratic Republic, Cambodia, and central Vietnam. This figure indicates that it is a serious public health problem in Thailand, particularly in northeastern and northern region. Objective: To survey the nutritional status among schoolchildren including the association between nutritional status and related O. viverrini infection that is reported in their living areas. Material and Method: A cross-sectional survey of nutritional status among schoolchildren was conducted in the rural communities of Surin province, Thailand, between September 2013 and July 2014. Nutritional evaluations, Socio-economic, and family information were collected through questionnaires. Four hundred sixty two children aged between 6 to 14 years were enrolled. Pearson correlation test and multiple logistic regression were used in this study. Results: Most respondents who answered the questionnaire were mother (37.23%), and followed by children (34.41), female (51.73%), and age rank older than 9 to 12 years old (41.99%). Schoolchildren were evaluated for weigh for age, which resulted in normal weight (60.82%), wasting (8.01%), underweight (7.58%), obesity (2.38%), and overweight (1.95%). Height for age was divided into normal height (60.17%), stunting (0.74%), slightly short (4.76%), tall (3.46%), and slightly tall (2.6%). Weight for height was divided into appropriate (54.11%), thin (10.82%), slightly thin (8.02%), obesity (2.38%), and morbid obesity (1.73%). Children were not infected with O. viverrini in this study even if 15.8% of them consumed undercooked particularly cyprinoid fish. Children with slightly underweight was statistically significant associated with O. viverrini infection (Adjust R square = 0.445, p<0.05). The equation for prediction of liver fluke infection among schoolchildren who had slightly underweight is Y = -0.508 + 0.517 X(12) and Z = 0.694 X(12). Conclusion: The present study indicates that stunting, underweight and wasting children were found in high infectious areas of O. viverrini. Slightly underweight was associated with infection. Therefore, implementation of nutrient in this group is urgently required. Furthermore, health education for children and relative family should be encouraged for further campaign in this province.

Analysis of Risk Areas of Opisthorchis viverrini in Rural Communities by Using SUT-OV-001.

Background: Opisthorchis viverrini is still a serious problem in rural areas of Thailand particularly Northeastern and Northern region. Active surveillance is required to determine the update data for further prevention and control planning. Objective: To determine the population at risk and analyze the risk areas for O. viverrini in rural communities of Nakhon Ratchasima province, Thailand. Material and Method: A cross-sectional survey was conducted between October 2015 and March 2016 at Kang Sanam Nang district, Nakhon Ratchasima province, Thailand. The population at risk for O. viverrini was screened by SUT-OV-001 with Cronbach' alpha coefficient, 0.724. O. viverrini infection was examined by using Kato thick smear. The risk areas were analyzed by using geographic information system. Results: Three hundred ninety seven people were recruited for this study. The majorities were female (53.15%), age group 41 to 50 years old (35.01%), educated with primary school (59.45%), agriculture (85.64%), and of income of 2,000 baht (47.36%). The majorities of them were high-risk (49.62%), followed by moderate risk (36.02%), and low-risk (7.3%). Risk areas were classified as very-high-risk areas, found in Beng Samrong (11.44 km(2)), followed by Keang Sanam Nang (5.21 km(2)). High-risk areas were found in Bueng Phalai sub-district (70.16 km(2)), followed by Bueng Samrong (30.45 km(2)), and Non Samran (27.33 km(2)). O. viverrini infection was 3.02%, and distributed in the moderate risk areas (four cases), high-risk areas (three cases), low-risk areas (three cases), and very-high-risk areas (two cases). Conclusion: The present study indicates the population at risk for O. viverrini and risk areas in the rural communities by using SUT-OV-001 and GIS. These tools are useful to display the risk areas for further prevention and control planning and monitor.

Primary Care Intervention to Prevent and Control Cholangiocarcinoma: Lesson from Nakhon Ratchasima, Thailand.

Background: Cholangiocarcinoma (CCA) is a bile duct cancer. It includes intra-and extra-hepatic bile duct. It is most commonly found in Thailand particularly in the northeast and north region. Those regions have been reported as the highest of incident of the world. Objective: Primary car interven in the risk areas of CCA among population in Nakhon Ratchasima province,Thailand. Material and Method: A community-based study was conducted among three districts of Nakhon Ratchasima province, Thailand including Bua Yai, Chum Phuang, and Mueang Yang district between July and December 2015. Mix method was used in this study that included cross-sectional survey, action research, and application of Geographic Information System. The study was composed of five steps, develop Korat CCA network, CCA screening by using Korat CCA verbal screening test, detection of liver fluke and CCA in the population at risk by using Kato Katz thick smear technique and ultrasonography, health behavior modification, and development of Geographic Information System for CCA database. Results: Three hundred fifty five participants were tested for liver fluke infection and the infection rate was found to be 2.25%. Eight cases from 88 participants at risk had a dilated bile duct. Populations at risk in each district were selected for health modification briefing that used the social engagement model. Seven community rules were agreed, cooked fish consumption, stop under-cooked fish, hygienic defecation, CCA campaign, food safety club, annual health check, an ongoing monitoring by village health volunteer and local public health officer. Conclusion: Infection in Nakhon Ratchasima is high. A community briefing and rules were agreed. A geovisual display of the population at risk for CCA is now available.

Localization of Tubulin from the Carcinogenic Human Liver Fluke, Opisthorchis viverrini.

BACKGROUND: Opisthorchiasis caused by Opisthorchis viverrini, is of considerable public health importance in Southeast Asia, particularly in Lao People's Democratic Republic and Thailand. The infection is associated with a number ofhepatobiliary diseases including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis, cholelithiasis and cholangiocarcinoma. OBJECTIVE: This study aims to localize the expression sites of 0. viverrini tubulin using immunohistochemistry by monoclonal anti α-tubulin (MAαT) and anti ß-tubulin (MAßT). MATERIAL AND METHOD: The adult worms of O. viverrini, and the adult worm of O. viverrini in biliary system of hamsters were fixed, cryo-sectioned and then immunohistochemically stained. The sections were incubated with MAαTor MAßT. A positive test required the observation of brown-staining in the fluke's organs. RESULTS: The immunohistochemistry of MAαT and MAßT in adult worms of O. viverrini, and the adult worm of O. viverrini in biliary system of hamsters strongly expresses in the sperm and seminal vesicles of the worm. MAαT and MAßT expressed slightly in sub-tegumental tissue, stromalparenchyma, muscle fibers, and miracidium in the mature egg of the worm. No staining in the spermatogonia, gut epithelium, immature egg, tegument or vitelline glands of the worm nor in the hamster bile duct epithelium was seen. CONCLUSION: The present study indicates that O. viverrini tubulin is present in the reproductive organs and other important organs of the worm. Because it plays a key role in the biological processes of cellular motility and fertility it should be further studied in detail including the characterization, production of recombinant proteases, and their application in immunodiagnosis.

Malaria Risk Areas in Thailand Border.

BACKGROUND: Malaria is a serious public health problem of the world especially in Africa and Asia where the areas are located in the tropical and subtropical regions. Malaria is a mosquito-borne infectious disease ofhumans caused by parasitic protozoans of the genus Plasmodium. OBJECTIVE: The present study aims to analyze the risk areas by using Potential Surface Analysis (PSA) with Geographic Information Systems (GIS) in Thai-Cambodia border including Buriram and Surin provinces. MATERIAL AND METHOD: The study divided the factors into six factors including population density, land used (agriculture, houses, water reservoirs, forest), anopheles adult density in villages with reported cases, average annual rainfall, average annual temperature, average annual relative humidity and analyzing risk areas by analysis of PSA. RESULTS: 846 malaria cases were reported between 2008 and 2012, 80.50% and 19.50% from to the Surin and Buriram provinces, respectively. The most cases were found in females, in the 31-40-year age group and agricultural people. The predominant cases were Plasmodium vivax with 45.36%. The high-risk areas of malaria cases was on the 3,014.79 kilometer Thai-Cambodian border consisting offour districts: Nangrong and Nondaeng districts of Buriram province and Sangka and Buached districts of Surin province. The relationship between malaria morbidity with environmental factors found that malaria morbidity rates were associated with land use (forest areas), population density, anopheles adult density of statistical significance and influenced morbidity rates by 12.3% (Adjusted R2 = 0.261), 17.0 (Adjusted R2 = 0.170), and 11.1 (Adjusted R2 = 0.111). The climate factor associated to malaria morbidity with average annual relative humidity by percentage of 5.7 (Adjusted R2 = 0.057). CONCLUSION: This study showed that malaria is still a problem in Thailand-Cambodia border and the analysis of PSA with GIS can be used to assess the risk of malarial morbidity, and lead to planning, control, and prevention of the morbidity.

Home Healthcare Program for Soil-Transmitted Helminthiasis in Schoolchildren along the Mekong River Basin.

BACKGROUND: Soil-transmitted helminths (STH) are among the most important groups of infectious agents responsible for physical and intellectual growth retardation in children worldwide. Current status is need requiredfor the development of control programs. OBJECTIVE: To determine the STH infections among the schoolchildren in the Mekong River basin near rural Ubon Ratchathani, Thailand and Champassak, Laos PDR, including their caregiver knowledge and attitude concerning prevention of STH infections. MATERIAL AND METHOD: A cross sectional survey was designed as a home healthcare programfrom October 2009 to April 2012. 1,957 fecal samples were collected from children aged 5-12 years in five districts of Ubon Ratchathani province (1,012 fecal samples; Khong Chiam, Si Mueang Mai, Phibun Mangsahan, Sirindhorn, and Pho Sai), Thailand, and one district of Champassak Province (945 fecal samples; Pakse), Lao PDR. Fecal samples were prepared by the modified formalin ethylacetate concentration technique, and determined by light microscope. The knowledge and attitude of children's caregivers concerning prevention of soil-transmitted helminth infections were completed interviewed by semi-structured questionnaires. RESULTS: The overall intestinal helminth prevalence rate was 11.88%. Classified by species the STHs were as follows: Ascaris lumbricoides (30.9%), Trichuris trichiura (21.7%), and hookworm (20.5%). The highest prevalence was recorded in children aged 9 years and above. The highest prevalence of STH infection was found in the Pakse district of Laos PDR (16.08%). The intensities of infection with A. lumbricoides, T trichiura, and Hookworm were 1.82 ± 0.36, 1.32 ± 0.30, and 1.29 ± 0.32, respectively. 1,077 of caregivers were completed interviewed and found that the caregivers had fair levels of knowledge and attitude regarding soil-transmitted helminthiasis. CONCLUSIONS: These results suggest that priority should be given to STH eradication, the development of control programs in the Mekong River Basin, and the provision of education about STH to caregivers to reduce the risk of STH infection in their schoolchildren.

A Cross-Sectional Survey of Intestinal Helminthiases in Rural Communities of Nakhon Ratchasima Province, Thailand.

BACKGROUND: The public-health problems caused by intestinal helminthic infections have been neglected in rural areas where there remains a lack of hygiene and an inadequate supply ofsanitary water OBJECTIVE: This research was to study the infection rate of intestinal helminthiases and socioeconomic data within two communities in Nakhon Ratchasima province. MATERIAL AND METHOD: Intestinal helminthiases were examined using Kato's Thick Smear technique and socio-demographic data was collected using predesigned semi-structured questionnaires. RESULTS: 209 stool samples were collected from 83 male and 126 female participants. Stool examinations showed that 6.22% (13/209) of study participants were infected with intestinal helminths, predominantly hookworm (4.31%, 9/209) followed by Strongyloides stercolaris (1.44%, 2/209), and Taenia sp. (0.48%, 1/209). Males were slightly more likely to be infected than females. Intestinal helminthic infection was more commonlyfound in the 61-70 year age group andpositively associated with occupation ofagriculture. The Tanod sub-district had an intestinal helminthiases rate of 10.59%, higher than in the Wang Sai sub-district. In conclusion, this study shows that intestinal helminthic infections are common parasitic infections among patients presenting for a small scale survey of a rural Thai community. CONCLUSION: This information may provide invaluable statistics needed for planning meaningful public control programs that aim at reducing the prevalence and morbidity of parasitic infections. Large scale surveys and health education are urgently required.

Risk Areas of Liver Flukes in Surin Province of Thailand using Geographic Information System.

BACKGROUND: Opisthorchiasis, caused by Opisthorchis viverrini, is of considerable public health importance in Southeast Asia, particularly in Lao PDR and Thailand. OBJECTIVE: This study aims to analyze the risk areas for liver flukes in Surin province, Thailand using Geographic Information Systems (GIS). MATERIAL AND METHOD: The 5 main factors (131 variables) were: (1) personal data (2) knowledge, attitude and practice, (3) health service unit, (4) environmental data, and (5) climate data. The relationship between these mainfactors and liver fluke infection was analyzed using multiple regression analysis. Potential surface analysis (PSA) with geographic information systems (GIS) was performed to create maps displaying areas at risk for liver fluke infection in Surin province. RESULTS: The population density (148-169 pop/km2; X73), human attitude (< 50%; X111), and land use (wetland; X64), were statistically significant with liver fluke infection by a percentage of 88.60% (Adjusted R2 = 0.886). The heavy risk areas covered 221.39 km2 and including 8 districts; Si Narong, Sangkha, Phnom Dong Rak, Mueang Surin, Non Narai, Samrong Thap, Chumphon Buri and Rattanaburi. CONCLUSION: Present study identifies the increased risk areas for liver flukes in Surin Province and may be useful for future planning of prevention and control.

Food-borne parasitic zoonosis: distribution of trichinosis in Thailand.

Trichinosis is among the most common food-borne parasitic zoonoses in Thailand and many outbreaks are reported each year. This paper investigates the distribution of the disease in regions of north, north-east, central and south Thailand. Between the earliest recorded of outbreak of trichinosis in Mae Hong Son Province in 1962 and 2006, there have been 135 outbreaks involving 7340 patients and 97 deaths in Thailand. The highest number of cases, 557, was recorded in 1983. Most infected patients were in the 35-44 year age group, and the disease occurred more frequently in men than women during 1962-2003, with no significant sex difference during 2004-2006. Outbreaks were most common in the northern areas, especially in rural areas where raw and under-cooked pork and/or wild animals are eaten. Human infections occur annually in northern Thailand during communal feasts celebrating the Thai New Year. Trichinosis causes have been reported every year, supporting the need for planning education programs.

Human intestinal capillariasis in Thailand.

Intestinal capillariasis caused by Capillaria philippinensis appeared first in the Philippines and subsequently in Thailand, Japan, Iran, Egypt and Taiwan; major outbreaks have occurred in the Philippines and Thailand. This article reviews the epidemiology, history and sources of C. philippinensis infection in Thailand. The annual epidemiological surveillance reports indicated that 82 accumulated cases of intestinal capillariasis were found in Thailand from 1994-2006. That made Thailand a Capillaria-prevalent area. Sisaket, in northeast Thailand, was the first province which has reported intestinal capillariasis. Moreover, Buri Ram presented a high prevalence of intestinal capillariasis, totaling 24 cases from 1994-2006. About half of all cases have consumed raw or undercooked fish. However, even if the numbers of the intestinal capillariasis cases in Thailand is reduced, C. philippinensis infection cases are still reported. The improvement of personal hygiene, specifically avoiding consumption of undercooked fish and promoting a health education campaign are required. These strategies may minimize or eliminate C. philippinensis infection in Thailand.

Opisthorchiasis in Thailand: review and current status.

Opisthorchiasis caused by Opisthorchis viverrini (O. viverrini) remains a major public health problem in many parts of Southeast Asia including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis, chole-lithiasis and cholangiocarcinoma. The liver fluke infection was induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas of Thailand. Health education programs to prevent and control opisthorchiasis are still required in high-risk areas.

Opisthorchis viverrini: the carcinogenic human liver fluke.

Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis and cholelithiasis. Multi-factorial etiology of cholangiocarcinoma, mechanical damage, parasite secretions, and immunopathology may enhance cholangiocarcinogenesis. Moreover, both experimental and epidemiological evidences strongly implicate liver fluke infection as the major risk factor in cholangiocarcinoma, cancer of the bile ducts. The liver fluke infection is induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas, of Thailand. The health education programs to prevent and control opisthorchiasis are still required in the high-risk areas.

The Effect of Health Behavior Modification Program for Liver Fluke Prevention among the Risk Group in Rural Communities, Thailand

This quasi-experimental research aimed to study the effect of health behavior modification program in relation to knowledge, self-efficacy, expectation, and practice for liver fluke prevention among the risk group from Bueng Samrong sub-district, Kaeng Sanam Nang district, Nakhon Ratchasima province, Northeast Thailand. The total of 66 participants was assigned to experimental and comparison group, 33 participants in each group, 12-weeks intervene period. The experimental group was received health behavioral modification programs based on health education, self-efficacy, motivation, social support and networking. Pre-and-post-tests were measured using predesigned questionnaires. The comparative analysis was analyzed by paired sample t-test and independent sample t-test at the 0.05 level of significance. The results revealed that the experimental group had significantly greater knowledge, self-efficacy, expectation, and practice for liver fluke prevention than those in the comparison group (p < 0.05). In conclusion, this was a successful health education program for liver fluke avoidance. Participants were gained the correct knowledge and had the higher self-efficacy, expectation, and practice regrading liver fluke prevention. Therefore, it may useful for further behavior modification in the other epidemic areas.

Genetic polymorphisms in TLR1, TLR2, TLR4, and TLR10 of Helicobacter pylori-associated gastritis: a prospective cross-sectional study in Thailand.

The toll-like receptors (TLRs) mediate the recognition of Helicobacter pylori and initiate the innate immune response to infection. We hypothesized those genetic polymorphisms in the TLR1, TLR2, TLR4, and TLR10 influence bacterial infection, affecting susceptibility H. pylori to disease outcomes. Genomic DNA was extracted and genotypes of TLR1 (rs4833095), TLR2 (rs3804099 and rs3804100), TLR4 (rs10759932), and TLR10 (rs10004195) polymorphism were detected by the TagMan single-nucleotide epolymorphisms genotyping assay using the real-time PCR hybridization probe method. The TLR1 (rs4833095), C allele and the TLR10 (rs10004195), A allele frequency was significantly increased risk in the H. pylori infection group (odds ratio=1.76, 95% confidence interval=1.84-2.15, P=0.01 and odds ratio=1.81, 95% confidence interval=1.18-3.26, P=0.04, respectively). The TLR1 (rs4833095), C allele and TLR10 (rs10004195), A allele are susceptible TLRs polymorphisms in the Thai population. These findings suggest that TLR1 rs4833095 and TLR10 rs10004195 may play crucial roles in H. pylori susceptibility and gastric pathogenesis.

Detection of Opisthorchis viverrini Infection among the ASEAN Population in Thailand Using a Verbal Screening Test and Fecal Concentrator Kit.

BACKGROUND: Opisthorchis viverrini is a serious health problem in Southeast Asia. The infection is associated with cholangiocarcinoma. Therefore, this study was aimed to detect O. viverrini infections among the ASEAN population in Thailand. METHODS: A cross-sectional study was conducted among 249 individuals from ASEAN populations in Thailand including Thai, Laotian, Cambodian, and Myanmar. Participants were screened using the O. viverrini verbal screening test (OvVST). Fecal samples were processed by the mini-parasep sf parasite fecal concentrator. RESULTS: The infection rate of O. viverrini was 27.21%. The majority of infections was detected in females, in the age group 31-40 yr old, in the primary school education level, and in the occupation of labor. By country, O. viverrini infection was detected more often in the Lao PDR (30.77%). In screening for O. viverrini infection, OvVST had a high sensitivity (93.48%), specificity (86.70%), NPV (98.32%), and accuracy (87.95%). The PPV was 61.43% for OvVTS. The observed agreement was substantial for OvVST (k-value = 0.64). CONCLUSION: O. viverrini infections are still detected in ASEAN countries therefore large scale active surveillance is required. OvVST had a high sensitivity, specificity, and accuracy for screening the risk groups for O. viverrini.

Active screening of gastrointestinal helminth infection in migrant workers in Thailand.

OBJECTIVE: This study aimed to detect gastrointestinal helminth infection in migrant workers in Thailand. METHODS: A cross-sectional survey study was conducted in 403 migrant workers in the factories of Nakhon Ratchasima Province, northeastern Thailand during October 2016 to June 2017. Gastrointestinal helminth infections were detected by the formalin ether acetate concentration technique and microscopy. The data were analyzed using the χ2-test and logistic regression. RESULTS: The rate of gastrointestinal helminth infection was 24.07%. The most common species involved in infection was O pisthorchis viverrini (11.91%), followed by hookworm (5.46%), Trichuris trichiura (5.21%), Strongyloides stercoralis (0.5%), Ascaris lumbricoides (0.5%), and Taenia spp. (0.5%). The majority of infections were found in men aged ≥40 years, married participants, uneducated participants, laborers, those who worked for 1 year, and those who had an income of 9000 to 12,000 THB. CONCLUSIONS: Gastrointestinal helminth infection is still found in migrant workers. Therefore, active surveillance is required in this large group for investigating and eradicating this type of infection.

Detection of Risk Groups for Carcinogenic Liver Fluke Infection by Verbal Screening Questionnaire Using a Mobile Application

The carcinogenic liver fluke, Opisthorchis viverrini, is a serious health problem in Southeast Asia where infection is associated with cholangiocarcinoma, a major cause of death in Thailand. This cross-sectional study aimed to screen for O. viverrini infection among a Thai rural population of 560 individuals from Nakhon Ratchasima, Khonkaen, and Chaiyaphum provinces with a verbal screening test with a mobile application (OvApp). Faecal samples were also processed with a mini-parasep sf parasite faecal concentrator. The infection rate of O. viverrini was found to be 2.86%. The majority of infections were detected in males aged 41­50, with primary school being their highest education level, and who were engaged in agricultural occupations. In screening for O. viverrini infection, the OvApp had a high sensitivity (87.5%), specificity (94.6%), negative predictive value (98.9%), and accuracy (98.6%). The positive predictive value was 70.0% for the OvApp. The observed agreement was substantial for this application (k-value = 0.64) indicated that it is a potentially useful tool for decreasing the cost of large-scale O. viverrini screening.

Knowledge, attitude and practice related to liver fluke infection in northeast Thailand.

AIM: To investigate the knowledge, attitude and practice (KAP) in prevention and control of liver fluke infection in northeast Thailand. METHODS: A descriptive KAP survey pertaining to liver fluke infection was carried out in June 2005 to October 2006 using structured questionnaires. Data were collected by questionnaires consisting of general parameters, knowledge, attitude, practice, and a history of participation in the prevention and control of liver fluke infection. RESULTS: A total of 1077 persons who were inter-viewed and completed the questionnaires were enrolled in the study. The majority were females (69.5%) and many of them were 15-20 years of age (37.26%). The questionnaires revealed that information resources on liver fluke infection included local public health volunteers (31.37%), public health officers (18.72%), televisions (14.38%), local heads of sub-districts (12.31%), doctors and nurses (9.18%), newspaper (5.72), internets (5.37%), and others (12.95%). Fifty-five point eleven percent of the population had a good level of liver fluke knowledge concerning the mode of disease transmission and 79.72% of the population had a good level of prevention and control knowledge with regards to defecation and consumption. The attitude and practice in liver fluke prevention and control were also at a good level with a positive awareness, participation, and satisfaction of 72.1% and 60.83% of the persons studied. However, good health behavior was found in 39.26% and 41.42% of the persons studied who had unhygienic defecation and ate raw cyprinoid's fish. The result also showed that 41.25% of the persons studied previously joined prevention and control campaigns. CONCLUSION: The persons studied have a high level of liver fluke knowledge and positive attitude. However, improvement is required regarding personal hygiene specifically with hygienic defecation and consumption of undercooked fish.